Can Your Uterus Cause Infertility or Miscarriage?

Can Your Uterus Cause Infertility or Miscarriage?

Abnormalities in your uterus can cause infertility, miscarriage and pregnancy complications. How can you tell if your uterus is normal? Let me explain the different methods available.

HSG (hysterosalpingogram)

There are three main techniques for evaluating the uterus. The first technique uses x-ray. It is called a hysterosalpingogram or HSG. Here's how it works:

After the bleeding from your period has ended, a doctor places a catheter into the uterus. Contrast, which is a liquid which shows up on x-ray, is squirted into the uterine cavity. The liquid fills the uterine cavity.

This test can tell if there are any abnormalities in the shape of the uterine cavity and if there are any growths or masses in the cavity. The HSG can also tell you if your tubes are blocked so it is a good choice for women who are just starting an infertility evaluation.

hsg uterus infertility

Saline ultrasound

The second technique uses ultrasound instead of x-ray. It goes by many names including hysterosonogram, sonohysterorogram, saline ultrasound or saline infusion sonogram. Saline is the medical term for salt water.

It starts out the same way as an HSG. A catheter is placed into the uterus and fluid is squirted into the uterine cavity. Instead of contrast, the fluid is saline and instead of doing an x-ray the doctor uses ultrasound.


By adding air bubbles to the saline, some doctors try to also evaluate the fallopian tubes but an HSN is not a great way to look for tubal blockage.

If you need to know about the tubes, HSG is a much better choice.


The third method is called hysteroscopy. Instead of using x-ray or ultrasound, the doctor puts a telescope into the uterus. For women who are considering IVF, we feel that this is the best method for evaluating the uterus.


In addition to being able to diagnose abnormalities in the shape of the uterus and growths and masses, hysteroscopy also allows the doctor to see the uterine lining and look for subtle problems like inflammation in the lining known as chronic endometritis.

Another advantage of hysteroscopy is that the doctor can also treat many problems at the same time as they are diagnosed. Hysteroscopy will not tell you if your tubes are blocked, however.

Our bottom line is this:

Any of these methods can be used to diagnose problems with your uterus that could be contributing to your infertility. Each method has pros and cons.

So the right choice depends on what type of fertility treatments you and your doctor are considering.